Before jumping on the gluten-free bandwagon, get tested

A loaf of gluten-free bread is pictured. For those with Celiac disease and gluten sensitivity, eliminating gluten (wheat, rye and barley) from their diet provides relief from unpleasant symptoms.

Photograph by: Bruce Edwards
, Postmedia News

REGINA — Got gut issues?

Thinking about going gluten free? It’s all the rage these days.

It’s become the diet of choice for everyone from Celiac disease sufferers to celebrities using it to control weight.

For those with Celiac disease and gluten sensitivity, eliminating gluten (wheat, rye and barley) from their diet provides relief from unpleasant symptoms, which include everything from abdominal pain, bloating and diarrhea to constipation.

But before changing your diet and jumping on the gluten-free bandwagon, get tested, recommends Shelley Case, one of North America’s leading gluten-free nutrition experts.

“If you go gluten-free before you get tested for Celiac disease, you can interfere with making an accurate diagnosis,” cautioned Case, a Regina dietitian, author of a best-selling gluten-free diet resource guide. “Because you have to be eating gluten when they do the blood test and the small intestinal biopsy to make the diagnosis.”

One in 100 people have Celiac disease, according to the Canadian Celiac Health Survey. And the average delay in diagnosis is 12 years.

“But we’ve estimated, of the one per cent of the population that has Celiac disease, only five to 10 per cent are actually diagnosed,” says Case. “There are lots of people who have Celiac disease right now that are wandering around — going to different doctors, naturopaths, the health food store — trying to figure out, ‘What will make me feel better?’ ”

If diagnosed with Celiac disease, it’s important to strictly follow a gluten-free diet for life. No cheating!

“You have to get rid of all gluten, not just the big sources,” Case explains. “For example, if you had a salad and there were croutons on it, and you were out at somebody’s place, and you just picked the croutons off, little bits of the crumbs have already soaked into the lettuce. And that little bit of crumb can be enough to cause damage to the small intestinal tract.”

“So we have to remove all gluten,” she said. “So we have to be really sure what we’re dealing with.”

The long-term complications of Celiac disease can include anemia, osteoporosis, cancer, and development of other autoimmune diseases, like thyroid disease, and arthritis.

“So the complications of Celiac disease are significant,” Case emphasizes.

“The good news is this is an autoimmune disease that we know the cause is eating gluten, and the solution is eliminating gluten,” she says.Sticking with a gluten-free diet is no picnic.

“But life is not over when you can’t have wheat flour,” says Case, who points out that there are plenty of gluten-free flours, cereals and starches that are allowed — including corn, flax, pulse flours, quinoa and tapioca.

While a gluten-free diet restricts grain options, the other three food groups in Canada’s Food Guide — vegetables and fruits, milk products, and meat and alternatives — can still be enjoyed.

“I try to show people that they still have lots of foods they can eat,” Case says.

Major advancements have been made in the development of gluten-free products, she says.

More flavourful, nutritious options are available. And there’s now a gluten-free regulation in Canada.

A gluten-free certification program has been introduced by the Canadian Celiac Association. President’s Choice and All But Gluten brands are the first major companies producing gluten-free products to have completed the certification program in Canada, Case says, but a total of 14 companies have been certified.

“It’s a very stringent certification program.”

The improved taste and increased variety of gluten-free products on the market make it easier for family members to support those with Celiac disease by eating many of the same foods.

But sticking to a gluten-free diet is challenging, admits Case, who has been consulting people on special diets for more than 30 years, and has been on a gluten-free diet for about four years.

“It’s more than just the obvious,” she cautions. “There’s gluten in soy sauce, salad dressing, marinades.”

“You need to work with a dietitian,” she recommends. “So you know what you can substitute .”

While some celebrities — including Miley Cyrus, Victoria Beckham and Gwyneth Paltrow — are promoting a gluten-free diet for weight control, Case finds that claim hard to digest.

She points out that gluten-free products use more starch to get breads, for example, to stick together, and have more fat and sugar added to make them palatable.

It’s not a healthier diet because there’s more fat and more sugar, and less fibre, she points out.

For individuals eating gluten free to control weight, “it’s the flavour of the month diet,” Case suggests.

For those with Celiac disease, on the other hand, “this is a diet for life that people have to follow.”

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